SHANNON ISLES
Private Revenue Health Services
Haverhill, MA,MA
1
Language
11
years of professional experience
Results-driven Account Receivable Specialist with over 5 years of experience in healthcare revenue cycle management. Focused on reducing outstanding invoices and enhancing cash flow through precise account reconciliation and discrepancy identification. Leverages financial software to improve accuracy and efficiency, ensuring timely reconciliation and elevated customer satisfaction.
Work History
ACCOUNT RECEIVABLE SPECIALIST
3 Months- Provided first-level customer support for billing, resolving 40+ patient inquiries daily to enhance customer satisfaction.
- Investigated denials and collaborated with insurance vendors to streamline claims resubmission process.
- Follow up on claims based on account aging and recovery priorities.
- Identified billing discrepancies in coding, charge entry, and cash application processes to ensure accurate billing.
- Review and prepare accounts for collections, communicating issues to management.
- Perform end-to-end account reconciliation and document collection on time.
- Provide first-level customer support for billing, resolving over 40 patient inquiries daily.
- Maintain accurate patient demographics and insurance data per HIPAA standards.
PATIENT ACCOUNT SPECIALIST
2 Years 6 Months- Managed insurance and patient correspondence, resolving balances and ensuring timely reimbursement.
- Analyze denial trends to identify root causes and support corrective actions.
- Partner with clinical teams to resolve account and payment issues and claims.
- Handled payer escalations through appeals, providing accurate documentation to support claims.
- Resolve complex accounts via research, follow-up, appeal, and resubmission.
- Resolved complex accounts through comprehensive research, follow-up, and effective appeals.
- Coach junior staff on claims follow-up and account research procedures.
- Develop checklists and workflows to improve consistency and reduce backlog.
PATIENT ACCOUNT REPRESENTATIVE
2 Months- Researched complex patient accounts to identify recurring denial and billing issues, enhancing accuracy in claims processing.
- Supported claims routing and follow-up, facilitating timely resolutions within the revenue cycle.
- Collaborate with teams to resolve billing issues and support resolution.
- Research complex patient accounts to identify recurring denial and billing issues.
- Prioritize work queue by account aging and recovery potential.
- Collaborated with teams to resolve billing issues, ensuring effective communication and streamlined problem-solving.
WORKERS' COMPENSATION CLAIMS RESOLUTION SPECIALIST
7 Months- Review and analyze workers' compensation claims for accurate reimbursement.
- Verified invoices and followed up on aging claims, ensuring timely payment and reducing delays.
- Partnered with PBMs and carriers to resolve documentation issues, minimizing rework and enhancing claims processing.
- Coach peers on claims documentation and workflow best practices.
- Establish prioritized follow-up to improve account resolution timelines.
- Support case tracking to enhance communication and claim visibility.
- Investigated billing discrepancies and reimbursement disputes, facilitating resolution and improving claim accuracy.
WORKERS' COMPENSATION REIMBURSEMENT SUPPORT SPECIALIST
7 Months- Executed administrative and data entry tasks to streamline reimbursement operations.
- Verify and correct data to maintain accurate reimbursement records.
- Prepare claims information and reports for management review.
- Coordinate treatment/record verification with payers for timely reimbursement.
- Partner with clinical and billing teams to resolve disputed charges.
- Compiled and submitted documentation and appeals to resolve reimbursement disputes.
- Liaised with insurers to facilitate reimbursements and secure necessary approvals.
- Review medical invoices to support accurate billing and reduce denials.
Education
Medical Billing & Coding
DIPLOMA
Skills
Medical Billing and Coding
Claims processing
Denial resolution
Receivables management
Account Reconciliation
Revenue optimization
Invoicing
Collections
EPIC and WAYSTAR
Compliance
Problem-solving
Communication
Accounts receivable
Investigative research
Dispute resolution
LANGUAGES
English
Timeline
ACCOUNT RECEIVABLE SPECIALIST
Private Revenue Health Services
09.2025 - 12.2025Read More
PATIENT ACCOUNT SPECIALIST
Acclara Solutions
08.2022 - 02.2025Read More
PATIENT ACCOUNT REPRESENTATIVE
Conifer Healthcare Solutions
01.2020 - 03.2020Read More
WORKERS' COMPENSATION CLAIMS RESOLUTION SPECIALIST
Injured Workers Pharmacy
01.2018 - 08.2018Read More
WORKERS' COMPENSATION REIMBURSEMENT SUPPORT SPECIALIST
Injured Workers Pharmacy, LLC.
01.2015 - 08.2015Read More
Salem High School
DIPLOMA
Read More
Northbridge University
Medical Billing & Coding
Read More